Clinical Trials Logo

Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT05946200
Other study ID # 2023/4146 (12662)
Secondary ID
Status Completed
Phase N/A
First received
Last updated
Start date May 20, 2023
Est. completion date June 25, 2023

Study information

Verified date July 2023
Source Konya City Hospital
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Laparoscopic cholecystectomy is one of the regularly performed laparoscopic surgical procedures. It resulted in shorter hospital stays, improved cosmetic outcomes, and reduced bleeding and pain. However, during laparoscopic surgeries, the pneumoperitoneum is known to raise intracranial pressure (ICP), reduction in cerebral blood flow (CBF), and as a consequence, cerebral hypoxia. There are various possible advantages of low-flow anesthesia. During laparoscopic procedures, low-flow anesthesia may be used as a means of preventing a rise in intracranial pressure and cerebral hypoxia. But low flow anesthesia effects on İCP are not known in Laparoscopic cholecystectomy. The primary aim of this study is to compare the effects of low-flow (0.75 l/min) and normal-flow (1.5 l/min) anesthesia on ONSD in patients undergoing laparoscopic cholecystectomy. Seconder aims are regional cerebral oxygen saturation (rSO2), bispectral index (BIS), and evaluate the status of cognitive function in the postoperative 24th hours.


Description:

Laparoscopic cholecystectomy is one of the regularly performed laparoscopic surgical procedures. It resulted in shorter hospital stays, improved cosmetic outcomes, and reduced bleeding and pain. However, during laparoscopic surgeries, the pneumoperitoneum is known to raise intracranial pressure (ICP), reduction in cerebral blood flow (CBF), and as a consequence, cerebral hypoxia. Near-infrared spectroscopy (NIRS), a noninvasive and continuous measuring method used to evaluate the appropriateness of cerebral perfusion, is therefore utilized in conjunction with cerebral oximetry to quantify regional tissue oxygenation. On the other, BIS is the most reliable technique for determining the level of sedation and anesthesia. Patients experience fewer intraoperative wake-ups thanks to BIS monitoring. Increased intra-abdominal pressure, decreased cerebrospinal fluid (CSF) absorption and obstruction of lumbar venous plexus drainage, increased pressure in the sacral spaces' vascular compartment, and cerebral vasodilation brought on by hypercarbia are some of the suggested mechanisms for why ICP increases during laparoscopy. Intraventricular and intraparenchymal catheterization remains the gold standard for determining and monitoring ICP. However, due to worries about severe complications like bleeding, infection, and equipment failure, invasive ICP monitoring during laparoscopic surgery is almost impossible. Recently, ultrasound-guided optic nerve sheath diameter (ONSD) measurement is a simple and reliable method of predicting elevated ICP. There are various possible advantages of low-flow anesthesia. It boosts mucociliary clearance, preserves body temperature, lessens fluid loss, generates savings of up to 75%, and lowers greenhouse gas emissions as well as the cost of treatment. It also improves the flow dynamics of the breathed air. During laparoscopic procedures, low-flow anesthesia may be used as a means of preventing a rise in intracranial pressure and cerebral hypoxia. But low flow anesthesia effects on İCP are not known in Laparoscopic cholecystectomy. The primary aim of this study is to compare the effects of low-flow (0.75 l/min) and normal-flow (1.5 l/min) anesthesia on ONSD in patients undergoing laparoscopic cholecystectomy. Seconder aims are regional cerebral oxygen saturation (rSO2), bispectral index (BIS), and evaluate the status of cognitive function in the postoperative 24th hours.


Recruitment information / eligibility

Status Completed
Enrollment 80
Est. completion date June 25, 2023
Est. primary completion date June 20, 2023
Accepts healthy volunteers No
Gender All
Age group 18 Years to 65 Years
Eligibility Inclusion Criteria: - Inclusion criteria of the patients will be determined as age between 18 and 65 years, ASA status 1-2. Exclusion Criteria: - Exclusion criteria of the patients are defined as patients younger than 18, pregnant women, patients with any ophthalmological disease affecting optic nerve diameters, patients with acute or chronic eye disease, patients using drugs known to affect intracranial pressure, and patients abusing alcohol or psychoactive substances.

Study Design


Related Conditions & MeSH terms


Intervention

Procedure:
Low flow technique in general anesthesia
It will be used a low flow technique by giving airflow as 0.75 l/min after the intubation and will keep going on until the end of the laparoscopic cholecystectomy.

Locations

Country Name City State
Turkey Konya City Hospital Konya Karatay

Sponsors (1)

Lead Sponsor Collaborator
Konya City Hospital

Country where clinical trial is conducted

Turkey, 

Outcome

Type Measure Description Time frame Safety issue
Primary Optic nerve sheath diameter. The primer outcome of this study is to measure optic nerve sheath diameter during by using low-flow (0.75 l/min) and normal-flow (1.5 l/min) anesthesia on ONSD in patients undergoing laparoscopic cholecystectomy. Intraoperative period
Secondary Regional cerebral oxygen saturation (rSO2) Seconder outcome 1 is regional cerebral oxygen saturation (rSO2) between low and normal flow technique. Intraoperative period
Secondary Bispectral index (BIS) Seconder outcome 2 is bispectral index (BIS) between low and normal flow technique. Intraoperative period
Secondary Cognitive function assessment by using Mini mental test Seconder aim 3 is to get Mini mental test score in the postoperative 24th.hours. Perioperative period.
See also
  Status Clinical Trial Phase
Completed NCT06367868 - Optic Nerve Sheath Diameter: A Non-Invasive Indicator of Intracranial Pressure in the Intensive Care Unit Monitoring N/A
Completed NCT04488874 - Sodium Lactate and Brain Relaxation (LSD) Phase 3
Not yet recruiting NCT04211064 - Comparison of the Effects of Deep and Moderate Neuromuscular Blockade on Optic Nerve Sheath Diameter N/A
Completed NCT00571623 - Automated Chest Physiotherapy to Improve Outcomes in Neuro N/A
Recruiting NCT00437814 - Effect of Ketamine (Ketalar) on Intracranial Pressure N/A
Recruiting NCT03212976 - Clinical Efficacy of a Non-Invasive Measure of Intracranial Pressure N/A
Withdrawn NCT02558309 - Optic Nerve Head Quantification While Reducing Elevated Intracranial Pressure N/A
Terminated NCT00795587 - Comparison of 2 Doses of Mannitol on Post Traumatic Intracranial Hypertension and Cerebral Monitoring Phase 4
Completed NCT00447018 - Mannitol Versus Hypertonic Saline Solution in the Treatment of Elevated Intracranial Pressure Phase 4
Not yet recruiting NCT05593380 - The Effect of BIA Monitoring of Brain Edema on the Neurological Prognosis of Supratentorial Massive ICH N/A
Completed NCT03364634 - Intracranial Pressure After Decompressive Craniectomy N/A
Unknown status NCT02773901 - Comparison of the Non-invasive ICP HeadSense Monitor vs Lumbar CSF Pressure Measurement N/A
Terminated NCT01973764 - Intraventricular Drain Insertion: Comparison of Ultrasound-guided and Landmark-based Puncture of the Ventricular System N/A
Terminated NCT00319345 - Sodium-Lactate and Traumatic Brain Injury Phase 2/Phase 3
Recruiting NCT04459806 - Intracranial PrEssure Time dOse (ImPETO)
Completed NCT00239525 - 3-D Transcranial Ultrasound Analysis Study N/A
Completed NCT03957837 - Optical Nerve Sheath Changes During Head Down Laparoscopy
Not yet recruiting NCT05818371 - Non-invasive ONSD-based Neuromonitoring in a Neurointensive Care Setting N/A
Completed NCT04429477 - Cerebral Compliance Impairment in COVID-19
Recruiting NCT03144219 - A Novel Non-invasive Technique of Cerebral Compliance and Auto-regulation Assessment